歯牙と連続性のない上顎エナメル上皮腫の1症例

Extradental ameloblastoma of the maxilla

はじめに

　エナメル上皮腫は歯原性腫瘍の1つであり，1827年にCusackら^1）によって初めて報告され，1930年にIveyら^2）によって病理学的検討がなされた。良性腫瘍として位置づけられているが，局所再発率が高いことが知られており，2〜5％の症例で遠隔転移が起こることも報告されている^3,4）。本腫瘍の発生母地は顎骨内の歯原性上皮であり，通常は歯牙と連続した形で発生するが，今回われわれは歯牙と離れた場所に発生した上顎エナメル上皮腫の1例を経験したので報告する。

　Ameloblastoma is a relatively rare odontogenic tumor that most frequently arises in the mandible. We herein report an extremely rare case of extradental ameloblastoma. A 60-year-old man was referred to our institute for a 6-month history of slowly progressing tenderness on his left cheek. He had been diagnosed with chronic sinusitis by a practitioner, and received macrolide therapy, which proved to be ineffective. CT and MRI revealed a multilocular cystic mass in the anterior wall of the left maxilla. By transnasal endoscopic biopsy, histopathological diagnosis of ameloblastoma was obtained. He eventually underwent complete resection of the tumor via Denker's operation. The tumor was separate from the teeth. The postoperative course was uneventful, and the patient has currently been free from disease 6 months after surgery.